Active NPI
Seo Young Lee, NP
- Pediatric Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1972017648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN298728
- Practice address
- 5730 Glenridge Dr Ste 200
Atlanta, GA 30328-5579 - Phone
- (404) 252-5206
- Fax
- (404) 252-1268
- NPI assigned
- Nov 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN685141 | PA | |
| Registered Nurse | 163W00000X | 26NR18993700 | NJ | |
| Pediatric Nurse Practitioner | 363LP0200X | SP018057 | PA | |
| Pediatric Nurse Practitioner | 363LP0200X | RN298728 | GA | Primary |
Addresses
Primary practice location
5730 Glenridge Dr Ste 200
Atlanta, GA 30328-5579
Mailing address
1930 Brannan Rd
McDonough, GA 30253-4310
Other names 1
- Carol Lee
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR18993700 | NJ | MD | Registered Nurse |
| RN685141 | PA | MD | Registered Nurse |
| RN298728 | GA | MD | Pediatric Nurse Practitioner |
| SP018057 | PA | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604966400000",
"number": "1972017648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 BRANNAN RD",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302534310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5730 GLENRIDGE DR STE 200",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303285579",
"telephone_number": "404-252-5206",
"fax_number": "404-252-1268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SEO YOUNG",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-16",
"last_updated": "2020-11-10",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN685141",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NJ",
"license": "26NR18993700",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "SP018057",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "RN298728",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROL",
"last_name": "LEE",
"credential": "NP",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.